Monotherapy with statins is frequently a very successful strategy to reach target plasma levels of LDL (low density lipoprotein) cholesterol (LDL-C) nevertheless in patients with mixed dyslipidemy and high cardiovascular risk which are typical for patients with metabolic syndrome and type 2 diabetes mellitus may not lead this therapy to target levels for compensation of dyslipidemy. To reach treatment goals it is necessary to use double or triple combination and hypolipidemics that can simultaneously influence complex abnormalities of lipid profile.
The most frequently used option is combination of a statin with fenofibrate or niacine (nicotinic acid); suitable is also a combination with omega-3 fatty acids or ezetimib. On combined treatment with hypolipidemics a careful monitoring of patients because of an increased risk of adverse effects and drug interactions is necessary.